scholarly journals Interpersonal counselling versus perinatal-specific cognitive behavioural therapy for women with depression during pregnancy offered in routine psychological treatment services: a phase II randomised trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jonathan Evans ◽  
Jenny Ingram ◽  
Roslyn Law ◽  
Hazel Taylor ◽  
Debbie Johnson ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Cognitive Behavioural Therapy ◽  
Health Workers ◽  
Psychological Treatment ◽  
Randomised Trial ◽  
Antenatal Depression ◽  
Behavioural Therapy ◽  
Low Intensity ◽  
Moderate Depression ◽  
Cognitive Behavioural

Abstract Background Up to one in eight women experience depression during pregnancy. In the UK, low intensity cognitive behavioural therapy (CBT) is the main psychological treatment offered for those with mild or moderate depression and is recommended during the perinatal period, however referral by midwives and take up of treatment by pregnant women is extremely low. Interpersonal Counselling (IPC) is a brief, low-intensity form of Interpersonal Psychotherapy (IPT) that focuses on areas of concern to service users during pregnancy. To improve psychological treatment for depression during pregnancy, the study aimed to assess the feasibility and acceptability of a trial of IPC for antenatal depression in routine NHS services compared to low intensity perinatal specific CBT. Methods We conducted a small randomised controlled trial in two centres. A total of 52 pregnant women with mild or moderate depression were randomised to receive 6 sessions of IPC or perinatal specific CBT. Treatment was provided by 12 junior mental health workers (jMHW). The primary outcome was the number of women recruited to the point of randomisation. Secondary outcomes included maternal mood, couple functioning, attachment, functioning, treatment adherence, and participant and staff acceptability. Results The study was feasible and acceptable. Recruitment was successful through scanning clinics, only 6 of the 52 women were recruited through midwives. 71% of women in IPC completed treatment. Women reported IPC was acceptable, and supervisors reported high treatment competence in IPC arm by jMHWs. Outcome measures indicated there was improvement in mood in both groups (Change in EPDS score IPC 4.4 (s.d. 5.1) and CBT 4.0 (s.d. 4.8). Conclusions This was a feasibility study and was not large enough to detect important differences between IPC and perinatal specific CBT. A full-scale trial of IPC for antenatal depression in routine IAPT services is feasible. Trial registration This study has been registered with ISRCTN registry 11513120. – date of registration 05/04/2018.

scholarly journals Interpersonal Counselling Versus Perinatal-specific Cognitive Behavioural Therapy for Women with Depression during Pregnancy Offered in Routine Psychological Treatment Services: A Phase II Trial.

2021 ◽  
Author(s):  
Jonathan Evans ◽  
Jenny Ingram ◽  
Roslyn Law ◽  
Hazel Taylor ◽  
Debbie Johnson ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Cognitive Behavioural Therapy ◽  
Health Workers ◽  
Psychological Treatment ◽  
Controlled Trial ◽  
Antenatal Depression ◽  
Behavioural Therapy ◽  
Maternal Mood ◽  
Low Intensity ◽  
Cognitive Behavioural

Abstract Background Up to one in eight women experience depression during pregnancy. In the UK, low intensity cognitive behavioural therapy (CBT) is the main psychological treatment offered for those with mild or moderate antenatal depression, but has limited relevance to the perinatal context. Referral by midwives and take up of treatment by pregnant women is extremely low. Interpersonal Counselling (IPC) is a brief, low-intensity form of Interpersonal Psychotherapy (IPT) that focuses on areas of concern to service users during pregnancy.To improve psychological treatment for depression during pregnancy, the study aimed to assess the feasibility and acceptability of a trial of IPC for antenatal depression in routine NHS services compared to low intensity perinatal specific CBT.Methods. We conducted a small randomised controlled trial in two centres. A total of 52 pregnant women with mild or moderate depression were randomised to receive 6 sessions of IPC or perinatal specific CBT. Treatment was provided by 12 junior mental health workers (jMHW). The primary outcome was the number of women recruited to the point of randomisation. Secondary outcomes included maternal mood, couple functioning, attachment, functioning, treatment adherence, and participant and staff acceptability. Results. The study was feasible and acceptable. Recruitment was successful through scanning clinics, only 6 of the 52 women were recruited through midwives. Treatment competence by jMHWs was high. 71% of women in IPC completed treatment. Women reported IPC was acceptable, and supervisors reported high treatment fidelity in IPC therapists. Outcome measures indicated there was improvement in mood in both groups (Change in EPDS score IPC 4.4 (s.d. 5.1) and CBT 4.0 (s.d. 4.8).Conclusions. This was a feasibility study and was not large enough to detect important differences between IPC and perinatal specific CBT. A full-scale trial of IPC for antenatal depression in routine IAPT services is feasible.Trial registrationThis study has been registered with ISRCTN registry 11513120. – date of registration 05/04/2018. https://doi.org/10.1186/ISRCTN11513120

scholarly journals Protocol for a feasibility randomised trial of low-intensity interventions for antenatal depression: ADAGIO trial comparing interpersonal counselling with cognitive behavioural therapy

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e032649
Author(s):  
Jenny Ingram ◽  
Debbie Johnson ◽  
Sarah Johnson ◽  
Heather A O'Mahen ◽  
David Kessler ◽  
...  
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Feasibility Study ◽  
Controlled Trial ◽  
Randomised Trial ◽  
Well Being ◽  
Behavioural Therapy ◽  
Advisory Group ◽  
Low Intensity ◽  
Cognitive Behavioural ◽  
Study Results

IntroductionOne in eight women suffer from depression during pregnancy. Currently, low-intensity brief treatment based on cognitive behavioural therapy (CBT) is the only talking treatment widely available in the National Health Service (NHS) for mild and moderate depression. CBT involves identifying and changing unhelpful negative thoughts and behaviours to improve mood. Mothers in our patient advisory groups requested greater treatment choice. Interpersonal counselling (IPC) is a low-intensity version of interpersonal therapy. It may have important advantages during pregnancy over CBT because it targets relationship problems, changes in role and previous losses (eg, miscarriage). We aim to compare CBT and IPC for pregnant women with depression in a feasibility study.Methods and analysisA two-arm non-blinded randomised feasibility study of 60 women will be conducted in two UK localities. Women with depression will be identified through midwife clinics and ultrasound scanning appointments and randomised to receive six sessions of IPC or CBT. In every other way, these women will receive usual care. Women thought to have severe depression will be referred for more intensive treatment. After 12 weeks, we will measure women’s mood, well-being, relationship satisfaction and use of healthcare. Women, their partners and staff providing treatments will be interviewed to understand whether IPC is an acceptable approach and whether changes should be introduced before applying to run a larger trial.Several groups of patients with depression during pregnancy have contributed to our study design. A patient advisory group will meet and advise us during the study.Ethics and disseminationStudy results will inform the design of a larger multicentre randomised controlled trial (RCT). Our findings will be shared through public engagement events, papers and reports to organisations within the NHS. National Research Ethics Service Committee approved the study protocol.Trial registration numberISRCTN11513120.

scholarly journals Physical exercise and internet-based cognitive–behavioural therapy in the treatment of depression: Randomised controlled trial

2015 ◽  
Vol 207 (3) ◽  
pp. 227-234 ◽  
Author(s):  
Mats Hallgren ◽  
Martin Kraepelien ◽  
Agneta öjehagen ◽  
Nils Lindefors ◽  
Zangin Zeebari ◽  
...  
Keyword(s):  
Physical Exercise ◽  
Cognitive Behavioural Therapy ◽  
Controlled Trial ◽  
Medical Practitioner ◽  
Work Capacity ◽  
Behavioural Therapy ◽  
General Medical Practitioner ◽  
Treatment As Usual ◽  
Moderate Depression ◽  
Cognitive Behavioural

BackgroundDepression is common and tends to be recurrent. Alternative treatments are needed that are non-stigmatising, accessible and can be prescribed by general medical practitioners.AimsTo compare the effectiveness of three interventions for depression: physical exercise, internet-based cognitive–behavioural therapy (ICBT) and treatment as usual (TAU). A secondary aim was to assess changes in self-rated work capacity.MethodA total of 946 patients diagnosed with mild to moderate depression were recruited through primary healthcare centres across Sweden and randomly assigned to one of three 12-week interventions (trail registry: KCTR study ID: KT20110063). Patients were reassessed at 3 months (response rate 78%).ResultsPatients in the exercise and ICBT groups reported larger improvements in depressive symptoms compared with TAU. Work capacity improved over time in all three groups (no significant differences).ConclusionsExercise and ICBT were more effective than TAU by a general medical practitioner, and both represent promising non-stigmatising treatment alternatives for patients with mild to moderate depression.

Cost-effectiveness and cost-utility evaluation of the individual vs. group transdiagnostic psychological treatment for emotional disorders in Primary Care (PsicAP-Costs) v2

2021 ◽  
Author(s):  
Angel Aguilera-Martin ◽  
Mario Gálvez-Lara ◽  
Fátima Cuadrado ◽  
Eliana Moreno ◽  
Francisco García-Torres ◽  
...  
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Emotional Disorders ◽  
Cognitive Behavioural Therapy ◽  
Psychological Treatment ◽  
Behavioural Therapy ◽  
Cost Utility ◽  
Cognitive Behavioural ◽  
Utility Evaluation ◽  
The Individual

The aim of this study is to compare, in cost-effectiveness and cost-utility terms, a brief transdiagnostic cognitive-behavioural therapy in two different modes, individual and group, with the treatment usually administered in primary care (TAU). Participants between 18 and 65 years old and with, according to the pretreatment evaluation, mild to moderate emotional disorders will be randomly allocated to the three clusters. They will be assessed again immediately after treatment and 6 and 12 months later. ClinicalTrials.gov: NCT04847310

Supporting low intensity interventions using the telephone

2010 ◽  
pp. 275-280 ◽  
Author(s):  
Karina Lovell
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Evidence Base ◽  
Behavioural Therapy ◽  
Practical Application ◽  
Low Intensity ◽  
Cognitive Behavioural ◽  
Therapy Interventions

Chapter 27 discusses LI interventions using the telephone, and aims to provide the rationale, evidence base, challenges, solutions and practical application of delivering low intensity psychological (mainly cognitive behavioural therapy) interventions by telephone.

scholarly journals Internet-based cognitive–behavioural therapy for prevention of depression during pregnancy and in the post partum (iPDP): a protocol for a large-scale randomised controlled trial

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e036482 ◽  
Author(s):  
Daisuke Nishi ◽  
Kotaro Imamura ◽  
Kazuhiro Watanabe ◽  
Erika Obikane ◽  
Natsu Sasaki ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Pregnant Women ◽  
Cognitive Behavioural Therapy ◽  
Post Partum ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Cognitive Behavioural ◽  
Randomised Controlled ◽  
Major Depressive Episodes ◽  
Depressive Episodes

IntroductionThe objective of this randomised controlled trial (RCT) is to examine the effects of smartphone-based cognitive–behavioural therapy (CBT) in preventing the onset of major depressive episodes (MDE) among pregnant women.Methods and analysisThe target study population will be pregnant women of 16–20 weeks gestation who are currently users of ‘Luna Luna Baby’, the most widely used app for pregnant women in Japan. Those who meet the eligibility criteria will be randomly allocated to the 6-module internet CBT programme that was newly developed for pregnant women (n=2500), or to a treatment-as-usual control group (n=2500). Participants in the intervention groups will be required to complete the programme by 32 weeks gestation. The primary outcomes are the number of new onsets of MDE, measured by using WHO Composite International Diagnostic Interview 3.0 at 32 weeks gestation and 3 months post partum. Survival analysis will be conducted to test for the effectiveness of the intervention on the time to the onset of MDE.Ethics and disseminationThe study plan has been approved by the Research Ethics Review Board of the Graduate School of Medicine/Faculty of Medicine, the University of Tokyo (2019150NI). If the intervention programmes are found to produce a significant positive effect in this RCT, these programmes can be made available for all users of the app in the future.Trial registration numberUMIN000038190; Pre-results.

scholarly journals Stepped care and cognitive–behavioural therapy for bulimia nervosa: randomised trial

2011 ◽  
Vol 198 (5) ◽  
pp. 391-397 ◽  
Author(s):  
James E. Mitchell ◽  
Stewart Agras ◽  
Scott Crow ◽  
Katherine Halmi ◽  
Christopher G. Fairburn ◽  
...  
Keyword(s):  
Bulimia Nervosa ◽  
Cognitive Behavioural Therapy ◽  
Relative Effectiveness ◽  
Randomised Trial ◽  
Behavioural Therapy ◽  
Individual Therapy ◽  
Stepped Care ◽  
Self Help ◽  
Treatment Conditions ◽  
Cognitive Behavioural

BackgroundThis study compared the best available treatment for bulimia nervosa, cognitive–behavioural therapy (CBT) augmented by fluoxetine if indicated, with a stepped-care treatment approach in order to enhance treatment effectiveness.AimsTo establish the relative effectiveness of these two approaches.MethodThis was a randomised trial conducted at four clinical centres (Clinicaltrials.gov registration number: NCT00733525). A total of 293 participants with bulimia nervosa were randomised to one of two treatment conditions: manual-based CBT delivered in an individual therapy format involving 20 sessions over 18 weeks and participants who were predicted to be non-responders after 6 sessions of CBT had fluoxetine added to treatment; or a stepped-care approach that began with supervised self-help, with the addition of fluoxetine in participants who were predicted to be non-responders after six sessions, followed by CBT for those who failed to achieve abstinence with self-help and medication management.ResultsBoth in the intent-to-treat and completer samples, there were no differences between the two treatment conditions in inducing recovery (no binge eating or purging behaviours for 28 days) or remission (no longer meeting DSM–IV criteria). At the end of 1-year follow-up, the stepped-care condition was significantly superior to CBT.ConclusionsTherapist-assisted self-help was an effective first-level treatment in the stepped-care sequence, and the full sequence was more effective than CBT suggesting that treatment is enhanced with a more individualised approach.

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